THE LAST WORD

Ten Sins of Office Medicine

None of us wants to be “that doctor.”

Keith W. Millette, MD, FAAFP, RPh

Fam Pract Manag. 2017 Jan-Feb;24(1):40.

Author disclosure: no relevant financial affiliations disclosed.

We have all heard our patients complain about bad experiences with other doctors: “That doctor misdiagnosed this,” “never explained what was going on,” “is always late,” or “only spent five minutes with me.” Deserved or undeserved, these critiques should cause all of us to strive not to be “that doctor.”

After reading the article “Seven Sins in Modern Medicine,”1 I decided to add to the list. Here are 10 sins I've seen or committed in my practice.

1. Not addressing the patient's expectations or hidden agenda. Some patients want an antibiotic for their viral infection, an x-ray or MRI for their back pain, or narcotics for their pain. When these interventions are not clinically indicated, clearly explain why – even if the patient does not directly ask you for them.

2. Not recognizing the patient's real problem. Examples include the patient who presents with chest pain but really has anxiety and depression, the patient who presents with upset stomach but really has unstable angina, or the 35-year-old patient who presents with bleeding hemorrhoids but really has colon cancer.

3. Not recognizing that the patient has been waiting. When a patient has had to wait more than 15 minutes, the first words out of your mouth when you greet the patient should be, “Thank you for waiting.” If possible, let your patient know why you are running late.

4. Not praising an excellent physician. When arranging consults with physicians you would be happy to see, let your patients know this fact so they can feel confident that they are in good hands.

5. Not properly educating the patient. If you want your patient to remember more than two things after the visit, put your instructions in writing. Visual aids also go a long way toward helping your patient understand what's going on. Patients who have just been diagnosed with atrial fibrillation, depression, diabetes, Parkinson's disease, etc., should be given a thorough handout explaining the disease in simple

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